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Neurology 2000;54:1681-1683
© 2000 American Academy of Neurology
Brief Communications

Clinical characteristics of pathologically proved cholesterol emboli to the brain

M. A. Ezzeddine, MD, J. M. Primavera, MD, J. Rosand, MD, E. T. Hedley–Whyte, MD and G. Rordorf, MD

From the Departments of Neurology (Drs. Ezzeddine, Rosand, and Rordorf) and Pathology/Neuropathology (Drs. Primavera and Hedley–Whyte), Massachusetts General Hospital, Harvard Medical School, Boston.

Address correspondence and reprint requests to Dr. Guy Rordorf, Massachusetts General Hospital, 55 Fruit Street, Blake 1291, Boston, MA 02114-2696; e-mail: grordorf{at}partners.org

Cholesterol emboli (CE) to the brain are an important but often unrecognized cause of stroke. The authors reviewed 29 cases of brain CE identified on autopsy. Most patients were elderly (mean age, 74 years) and presented with encephalopathy and acute renal failure. Ten patients developed symptoms spontaneously, 19 after a procedure involving manipulation of the aorta. Brain imaging revealed multiple, small ischemic lesions and border zone infarcts in 11 of 17 patients. Pathology in most patients demonstrated multiple CE mixed with emboli of other types.

Key words: Cholesterol emboli—Stroke—Border zone infarcts.




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